Don't bother with foods that lower cholesterol

Health conscious shoppers should not bother with spreads, yogurts and drinks
that lower cholesterol because there is not evidence that they are good for
your heart, the NHS rationing body has said.

NICE recommends that patients at risk of heat attack or stroke should be given statinsPhoto: ANDREW CROWLEY

By Rebecca Smith, Medical Editor

8:40PM BST 30 May 2008

Doctors should not recommend that patients at increased risk of having a heart attack or stroke use the foods to lower their cholesterol, the National Institute for Health and Clinical Excellence says in guidance.

GPs should instead prescribe statins, which are proven to reduce the risk of cardiovascular disease, the document said.

They lower the levels of bad cholesterol and increase the levels of good cholesterol in the blood, which has been proven to improve the health of the heart and reduce the chances of a heart attack or stroke.

The spreads and yogurts contain plant sterols and stanols, which help lower bad cholesterol levels by blocking its absorption from the bloodstream. However, although they lower cholesterol, Nice says it is not clear whether using them lowers the risk of a heart attack.

Flora pro.activ and Benecol, which are the market leaders in cholesterol-lowering foods, sell £500 million-worth of products between them across Europe each year.

The guidance document produced by Nice and aimed at patients says: "If you are at higher risk (of a heart attack or stroke within the next ten years) your GP or nurse will not recommend that you use spreads, drinks and yogurts containing plant sterols and stanols to lower cholesterol because there is not enough evidence at the moment that these products prevent cardiovascular disease."

Dr Ian Campbell, a GP and medical director of the charity Weight Concern, said that although Nice was sticking to the absolute proven evidence, there was also room for a common sense approach.

"If my patients ask me if they can use Benecol or Flora pro.activ to lower their cholesterol I would say, 'Yes, no problem.' It gives patients a sense of control and that they are doing something to help themselves as well as getting them to focus on their diet.

"But they would not get the same effect as with a statin and so those at high risk should not rely on these products alone."

He said that as far as bad cholesterol was concerned, the lower the level the better.

A spokesman for Unilever, which makes the Flora pro.activ range, said: "There is a great wealth of evidence that reducing cholesterol leads to reductions in risk of cardiovascular disease.

"Under current legislation it is not possible for a food to make disease risk reduction claims, and as such Flora pro.activ only makes claims about reducing cholesterol in all communications."

A spokesman for Nice said: "There is evidence that foods containing plant sterols and stanols reduce cholesterol levels. It is generally supposed that reducing cholesterol levels leads to reductions in cardiovascular disease (heart disease and stroke) however this is not necessarily always the case.

"Some substances may lower cholesterol, but there may not be evidence to say clearly that they also prevent cardiovascular disease."